10-1168 (SFD)P.O. BOX 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
c&ht 4- 4 QuAlz
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 10-00001168
Property Address: 81159 CASPIAN CT
APN: 764-280-004-27 -35996 -
Application description: DWELLING SINGLE FAMILY DETACHED
Property Zoning: LOW DENSITY RESIDENTIAL
.Application valuation: 180549
,Applicant: Architect or Engineer:•
.LICENSED CONTRACTOR'S, DECLARATION
I hereby _affirm under.penalty of, perjury that arnMeensed under provisions of Chapter'9 (commencing with
Section 70001 of Division 3 of the Businel and Prof ionals Code, and my License is In -full force and effect.
Licena Class j, Li nse No.: 672285'
Date• v antractor•.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that l am exempt from the,Contrsctor's+State License Law for the
following reason (Sec. 7031.5, BusinessandProfessions Coder Any city or county that requires a permit to
construct,, alter, improve, demolish, or repair anystructurs, prior to its issuance, also requires the appllcant.for the
permit to file a signed statement that he orahe is licensed pursuant to the provisions of -the Contractor's State
License Law (Chapter 9 (commencingwith Section 7000bof Drvision1 of the Business-and.Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5'by
any applicanvtor a permit subjects the applicant to a<civil penatty.of not more then five hundred dollars ($500).:
1, as owner of the property, or my employees with wages: as'their sole compensation, will, do the work; and
the strueture'is not Intended orvffered for. sale (Sete 7044, Business and Professions Code. The
Contractors' State License Law'does not:apply to an owner of propertywho builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided thatthe.
1mprovemenware not intended or offered for sale. If, however, the,buildingror improvemem'ls{sold within
one'year of completlon,'the owner-buiiderwill.have the: burden of proving that he or she did not build or
improve for the purpose of sale.).
(_) I; as owner of the property,.am exclusively contracting with licensed. contractorsAo,construct the, project (Sec.
7044,LBusiness and Professions,Code The Contractors' State License taw does not.apply to an owner of
property who builds or Improves thereon; and who cootracts.for the projects,with a contractor.(s),Ilcensed
pursuant to the Contractors' State License Law.).
(_) I;am exempt under Sec. , B.&P.C..for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I herebyaffirm: under.penalty. of,perjury'that,there, is:a construction lending agency for the performance of the,
work -for which this permit Is Issued (Sec. 3097, Civ. C.).
Lendeds Name:
Lender's'Address:
GQPERMTT
Owner:
SHEA LA QUINTA
60800'TRIL0GY PARKWAY
LA QUINTA, CA 92253
Contractor:
SHEA HOMES, INC.
60800 TRILOGY PARKWAY.
LA QUINTA, CA 92253
(7.60)777-6032
Lic. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/03/10
WORKER'S COMPENSATION DECLARATION
I hereby affirm under pen" of perjury one of the following declarations:
I have and.will maintain certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, tot the performance:ot the; work for which,this permit is
�( issued.
I� Lhave -and will mai main workers' compensation insurance,.as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit 41asued. My workers' compensation
insurence carrier and,policy number are;
Carrier. -LIBERTY MUTUAL Policy Number WA266DO66115030
_ I certiiythat, in the, performance of thework for which4his permit is Issued, I shall not employ any
person?in any manner so as to become subjecuto the workers' compensation laws of,Califomia,
and agree th""st, if l should becomesubjact to the workers' gompensationprovisions of. Section
3700 of the Labor Code I II fotthwith c (nply with those provisions.
/Det% pplicant:
WARNING: FAILURE TO SECURE, WORKERS''COMPENSATION COVERAGE IS UNLAWFUL,.AND SHALL
SUBJECT AN.EMPLOYER T0. CRIMINAL PENALTIES AND CIVIL FINES 'UPTO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN. ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED, FOR IN
SECTION 3708 OF THE LABOR CODE; INTEREST; -AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made.to the Director of Building and Safety for a, permit subject to the
conditions, and restrictions set forth on this application.
1. Each person upon whose on,
this application is made, each person at whose.requast and for
whose benefit work is.performed under or pursuant to any permit issued as a result of this application,
the owner, and ,the applicant, each agrees to,.and shall defend, indemnifyiand hold harmless the City
of La,Quinta, Its officers; agents and employees for any act or omission related.to the work being
performed under or following Issuance,of this permit.
2. Any permit issued as a result of this.applicatlon beeomesmull and void if^work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
Permit to cancellation.
I certify that I have read this applicatiomand state that the:above informations correct. I agree to comply with all
city and.cordinances and state Taws relating to building construction, aril hereby authorize representatives
of this u, enter upon he above-mentioned property for ins ection.purposes.
to gnature (ApplicantorAgent):
i
LQPEmKTT
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Application Number . . . . 10-00001168
Permit.
. . .
BUILDING PERMIT
Additional
desc .
Permit Fee
. . . .
923.00
Plan Check Fee
149.98
Issue Date
Valuation . . . .
180549
Expiration
Date
5/02/_11
Qty Unit Charge
Per
Extension
BASE
FEE
63.9.50
81.00
3.5000
THOU BLDG
100,001-500,000
283.50
Permit
. . .
MECHANICAL
Additional
desc .
Permit Fee
. . . .
110.50
Plan Check Fee
6..90
Issue Date
. .
Valuation . . . .
0
Expiration
Date
5/02/11
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2.00
9.0`000
EA MECH
FURNACE <-=100K
18.00
1.00
9..0000
EA MECH
B/C <=3HP/100K BTU
9.0.0
1.00
.16.5.000
EA MECH
B/C >3-15HP/>10.0K-500KBTU
16.50
6.00
6.5000
EA MECH
VENT FAN
39.00
2.00
6.5000
EA MECH
EXHAUST HOOD
--------------
13.00
Permit.. . . ELEC-NEW RESIDENTIAL
Additional desc . .
Permit Fee . . 9.8_.76 Plan Check Fee .
Issue Date . . . Valuation . . . .
Expiration Date . . 5/02/.11.
6.17
0
Qty Unit Charge Per Extension
BASE FEE 15.00
2028.00 .03'50 ELEC NEW RES - 1 OR 2 FAMILY 70.98
639..00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 12.78
Permit . . PLUMBING
Additional desc . .
Permit Fee . . . . .147.75
Issue Date . . .
Expiration Date . . 5/02/11.
Qty Unit -Charge Per.
BASE FEE
13.00 6.0.000 EA PLB FIXTURE
Plan Check Fee . . .9.23
Valuation . . . . 0
Extension
15.00
78.00
Y
LQPERMIT
y
Application Number . . . . 10-00001168
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
1.00 15.0000 EA PLB BUILDING SEWER
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM
9.00
7.00 .7500 EA PLB GAS PIPE >=5
5.25
1.00 15.0000.EA PLBGAS METER
15..00
Permit. . . . GRADING PERMIT
Additional desc .
Petmi"t Fee 15.00 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration Date 5/02/1"1
Qty Unit Charge Per
Extension
BASE FEE
15.00
Special Notes and Comments
SFD - LOT 27, PLAN 4515C, 2028 SF.
INCLUDES 255 SF. DETACHED CASITA,24 SF
BAY CES NOOK & 103 SF. GARAGE EXTENSION.
PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK
WALLS OR DRIVEWAY APPROACH. 75%
REDUCTION TO PLAN CHECK FEES DUE TO
MULTIPLE ISSUANCE OF SAME PLAN TYPE.
2007/2008 CODES. 2010 PLAN UPDATE.
---------------------------------------------------
--------------- _-
Other Fees . . . . . . . BLDG STDS.ADMIN, (SB1473)
8.00
DIF COMMUNITY CENTERS -RES
74.00
'DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
15.00
DIF FIRE PROTECTION -RES
140.06
GRADING PLAN CHECK FEE
:00
DIF LIBRARIES• - RES
355.00
MULTI -SPECIES (MSHCP) FEE
1284.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892."00
STRONG MOTION (SMI) - RES
18.05
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION -.RES
1930.00
Fee ."summary Charged Paid Credited
Due
Permit Fee Total 1295.01 .00 .00
1.295.01
Plan Check Total 172.28 .00 .00
172.28
Application.Number . . . . . 10-0000.1168
Other- Fee Total 5800.05 .00 .00 580.0.05
Grand Total. 7.267.34 .00 .00 7267.34
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